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Between embarrassing flare-ups and specialized diet requirements, socializing can be challenging with Crohn's disease.

Tune in to get strategies for dining out, eating at parties and navigating buffet tables without embarrassment. Find out what ingredients to avoid at the restaurant and swap Crohn's-friendly recipes for your next dinner party.

And, as always, experts answer questions from the audience.

Announcer:

Welcome to this HealthTalk show. Before we begin, we remind you that the opinions expressed on this show are solely the views of our guests. They are not necessarily the views of HealthTalk or any outside organization. And, as always, please consult your own physician for the medical advice most appropriate for your. Now, here’s your host.

For someone living with Crohn's disease, going out to dinner, attending social events and traveling can sometimes be frightening and almost always challenging.

Being prepared ahead of time can make social events and traveling a lot easier and may help you avoid accidents. So during this show, we’ll discuss how to get ready to eat out and hear tips for handling embarrassing situations with our expert panel.

Joining us is Jill Sklar. Jill is an award winning writer and the author of three internationally distributed books including, “The First Year Crohn’s Disease and Ulcerative Colitis,” “Eating for Acid Reflux: A Handbook and Cookbook for Those with Heartburn” and “The Five Gifts of Illness: A Reconsideration,” that’s releasing this spring. Jill is also a board member and former vice president of the Michigan Chapter of the Crohn’s & Colitis Foundation of America and was diagnosed with Crohn’s disease 18 years ago.

Also with us is Kevin Freeman. Kevin is the president and founder of GK Media, a Canadian company that publishes online restaurant guides like foodvancouver.com, foodseattle.com and toronto.foodontario.com for people with dietary restrictions due to conditions like Crohn’s disease, high blood pressure or diabetes. With the help of dieticians, he and others critique restaurants with these special dietary needs in mind. Freeman himself has Crohn’s disease and is a long-time member of the Canadian Society of Intestinal Research.

Jill, having Crohn’s yourself, I’m sure there have been times where you were fearful in a social situation. Can you tell us what kind of problems can arise for someone with Crohn’s when eating out or attending other social events like weddings and parties?

Jill Sklar:

Problems really arise in two areas. The first one is being in control of the menu and what you are consuming. The second one is having access to a bathroom.

Mary White:

Kevin, you also have Crohn’s. Would you like to add anything to that?

Kevin Freeman:

I think the biggest things are trying to control the anxiety and getting used to controlling your emotions and then using Jill’s tips.

Mary:

So what kinds of things could be done to prevent those situations from happening?

Jill:

When you are in your home, you are in total control of the situation. You likely have a bathroom that’s always available to you, you likely have things in your cupboard or your refrigerator that you know are safe to eat, and you can control the type of cooking that’s going to be done. But when you leave your home, you lose that control, so you have to regain it. In the first situation, you ask what is on the menu. When the menu is not clear about the ingredients or the method in which the dish is being prepared – ask! In the United States, there are laws that require the restaurant to disclose the ingredients of a dish. Avoid the things that are coated with crumbs that are fried, that are fatty, that are sautéed and instead chose things that are baked, broiled or boiled. If you are having problems with a narrowing within your intestines, avoid things that have too much roughage in them. If you are going to an event that is planned by others like a wedding or a party, call ahead and explain your desire to attend as well as your dietary restrictions and then ask what’s on the menu. You have a legitimate reason to do so because Crohn’s is a medical condition, and what you eat can make you sick. Most hosts or hostesses are very happy to accommodate you, make an arrangement for a special plate to be served to you, and the vast majority of caterers to events have been inundated with these types of requests for various conditions from celiac disease to IBS. However, if they can’t accommodate your needs, be sure that you can eat before the event or bring something along in your purse or in your pocket that can tide you over until you can get home.

As far as bathroom access is concerned, I tend to use the restroom as soon as I arrive in any type of situation where I know I’m going to be out for a while. That way, I know where the bathroom is located. Of course, I also want to wash my hands before I eat. But I also do it for another reason. In a restaurant, the accommodations within the restroom are very indicative of the accommodations within the kitchen. If it’s very messy, if there are paper towels all over the floor, if there’s soap all over the counter, you can imagine what it is going to look like in the kitchen. This is what they are showing their customers, and that’s supposed to be their best face. If it doesn’t look hygienic, imagine what it looks like behind closed doors in the kitchen.

Another thing that you can do in participatory events like picnics and parties is ask the organizers if you can bring a dish to pass. That way, you’ll know that there is at least one thing that you are positive that you can eat. If they say no, check the menu. If there is nothing there that you can eat, then you can eat before.

Every year, for example, I host a block party barbecue for my neighbors, and I spring for the main dishes because then I know I can eat them. Usually, I can have one or two of the other things, but I know that I’ll be able to eat the main dish. I finish up the evening with some tofu ice cream sandwiches, which are always a big hit.

Mary:

Kevin, when you go out with your friends in the evening, how do you prepare?

Kevin:

Normally, I go to my own Web site, foodvancouver.com and check to see which restaurants provide the services. From there, it’s communication with the waiter. It starts by explaining what you have and looking at the menu. It comes down to communication between the waiter, yourself and the chef. Everyone wants you to have a good time because if you’re not having a good time, the chances are you might not go back to that establishment.

The key is communication. Most people are fine with it, if you are nice about it. I’ve had people in Arby’s pick sesame seeds off buns for me because I can’t handle them. All I did was just ask in a nice way.

Mary:

Kevin, you mentioned your Web site. Can you tell us more about that and how do people get access to it?

Kevin:

Well, there’s foodvancouver.com for Vancouver residents foodseattle.com for Seattle residents and toronto.foodontario.com is for the Toronto residents. It is free, and the restaurants can simply add the information on what special dietary needs they are able to cater to. The site is a full dining guide for everybody with or without special dietary needs, but it’s got this great section for people with special dietary needs. The whole point of it is inclusion, so I and others with special dietary needs can feel part of the whole foodie community.

Mary:

What do you do if the worst happens and you have an accident or you just start feeling really awful when you are out? Kevin, how do you handle that?

Kevin:

Normally, my stomach will be pretty distended. I can feel it coming on, and I can control my pain, and I’ll just look at my wife. Or I’ll just excuse myself and hopefully be able to make it home. If not, obviously, I go to the bathroom right away. But if it’s really bad, I need to get the heating pad and just curl up in a ball at home, and then hopefully it will pass. If not, then it’s, unfortunately, off to the local emergency, and you know the drill. You just go in, and before you know it you’re given some treatment rather quickly.

Mary:

Jill, how about you?

Jill:

I try to avoid accidents by making absolutely sure that there are bathrooms wherever we go, and I prefer to go to places that have more than one restroom stall. There is one restaurant, for example, that I absolutely love. But it has one restroom for women and about 30 tables, so the chances of me waiting in line when I really have to go are very high, and, therefore, I avoid that restaurant, unfortunately. I also make sure that I take some anti-diarrheal medication, like Imodium (loperamide), before I leave for a night out. If all else fails, I have a pair of underwear in a Ziploc bag in my purse. If an accident happens, at least I have a spare, and I have a place to store the dirty underwear in a nice Ziploc place in the bottom of my bag.

Mary:

That’s perfectly practical. It makes sense. Usually, social events are your friends – close friends – no big deal, but some people do have to attend business dinners, company parties and things like that on a regular basis. Do those situations create additional problems or change those dynamics?

Kevin:

I would say that they do. For me, obviously, because I’m on the Web and I have Crohn’s, whenever I meet somebody for business, it’s kind of a given. If you are uncomfortable with telling people, it can be quite anxiety-driven. If you are just meeting somebody for the first time, you have to be very confident. I think that’s the biggest thing. If somebody asks why are you ordering a low fiber meal, then you just simply say, “Well, I have Crohn’s disease,” and then they know, and you move on. It’s not the end of the world. It happens and that’s it.

Mary:

Jill, how about you?

Jill:

Most people have dietary concerns. Whether it’s my husband who’s been on and off the Atkins diet more times than I can recall, or if it’s my child who does not particularly do well with certain vegetables or if it’s me who is on the low fiber diet or have to avoid things that are fatty or fried. Think about diabetes as the number three killer in the United States. That means there are millions of people out there who have this condition. There are people who have heart conditions – that’s the number one killer in the United States. They also have special dietary concerns. Any disease that is life-threatening, chronic or acute, especially ones that affect the digestive tract will definitely require some type of special ordering, so I don’t think twice about it at all – and neither should anyone else. This is not something that you should hide.

Mary:

That’s very practical, and I totally agree with you. A lot of our listeners are parents of children with Crohn’s. Do you have any advice about how a parent should deal with a situation like a birthday party or a school event where food is served?

Jill:

Well, I’m a parent as well. I have an 11-year-old boy, and I know that you have to treat dietary restrictions just as you would a food allergy. For example, anytime a child comes into my house who I’m not familiar with, I’ll ask the parent beforehand, “Is your child allergic to any foods?” because I don’t want a child having anaphylactic shock in the middle of a play date. No parent hosting a party would even think of serving peanut butter to a child with a nut allergy, nor would they want your child with Crohn’s to feel uncomfortable either. So, because of this, parents of children with Crohn’s disease should definitely feel comfortable calling the host of the children’s party and talking about your child’s needs in terms of diet and bathroom access before the party begins. Just a brief explanation is necessary, and I guarantee that most people would be happy to accommodate you and your child. And if not, avoid the party.

Mary:

What about a school event like cake, cupcakes and stuff like that?

Jill:

Generally speaking, most children can do cake and cupcakes even with Crohn’s disease. Things that they would have to avoid might include pizza and salad. In that situation, you might want to say, “Could he have something like noodles?” or suggest something else that the child might have. Or even say, “Listen, my child has these certain concerns and if you are not serving these things, would you mind so much if I packed something for him to have?”

Mary:

We’ve heard about some of the challenges with eating out and attending parties, but can you talk about the issues someone with Crohn’s might face when traveling?

Jill:

Sure. I travel all the time. Believe me when I tell you that you can and should travel with this condition. Life is to be lived, and traveling is part of that, so don’t let Crohn’s hold you back. It helps to chart the trip on a map and then consult Web sites to find out where bathrooms are located. There are travel pages in every state government Web site that tell you exactly where the public rest stops are located along the interstates. Every major fast food restaurant has a Web site. And on these Web sites are store locator functions. Fast food restaurants will not kick you out for just using the restroom. Simply plot these points on your driving maps to make sure that you always have bathroom access.

In the car, bring a roll of toilet paper. If it ends up that nature calls before you can reach such a stop, just simply pull over, and open the door on the roadside to block the view of oncoming cars. If animals can do it in nature, so can you.

As far as plane trips are concerned, I try not to eat before I get to the airport, which helps me to avoid the bathrooms until I’m through at least security. Once I’m on the plane, I stop the flight attendants the moment I get on the plane. And then I tell them of my condition and my reliance on the bathrooms. They usually invite me to use the first class bathrooms if the ones in coach are being used. They also tell me to push the little button above the seat to signal for their help if I need to use the restroom when the fasten seatbelt sign is on. Sometimes, they have moved my seat to a location that helps them to identify me and my needs. I also let them know that I may need to walk up and down the aisles on longer flights as my Crohn’s has given me the possible predisposition for blood clots. So on longer flights, you want to get up every two hours and walk the length of the plane.

As far as trains are concerned, you can check out the menus before you even board as all of these are posted online. And if there is nothing that appears safe for you to consume, bring your own food in the form of Rice Krispie treats, or bagels or other pre-packed snacks. But also make sure that you tell the stewards or the employees when you are boarding that you may need greater bathroom access. This will allow them to realize that there may be a need to help you, during a trip, to find other restrooms if those in your car are being taken at the moment.

If you plan to take a cruise, realize that there are several things for you to do to insure your safety and health. First, bring hand sanitizer with you and always wash your hands before you eat. There have been several reports in recent years of major breakouts of gastrointestinal viruses aboard these vessels. Also, it’s wise to check out the health inspection reports of the various vessels before ever boarding them. To do so, go to the Center for Disease Control Web site, and you’ll find a section on cruise ship inspections and read the inspections for your cruise ship. If it doesn’t look like it’s going to be safe to the health inspectors, it’s probably not going to be safe to you.

They are in charge of inspecting any cruise ship that comes to an American port. The chances are you are going to leave from an American port. And if that’s the case, they have to inspect them, and they have to inspect them on a regular basis, so you can read some really recent reports. You want to check the food handling report. You don’t want to get some bacterial infection while you are out to sea. This is not a good idea. You want to see how it stacks up. And actually, it’s true that you can also access a lot of health department reports across the country, county by county, to find out which restaurants are safe to eat in because they are required to keep records on all restaurants in the United States according to local health departments.

Mary:

Now, are trains looked at by the CDC as well?

Jill:

I’m not sure if the trains are looked at, but I am sure there is probably some agency that would be required to because any food handling in the United States has to be covered in under USDA (United States Department of Agriculture) and the FDA (Food and Drug Administration).

Mary:

Kevin, did you have anything you want to add to that?

Kevin:

Well, I’m going to Mount Everest in October, and I’m starting to plan now. So it’s a 21-day trek through Nepal and then up to about 14,000 feet up. I’m already looking at the travel clinic and making sure I’ve got all the appropriate shots, and the appropriate medications. I’m sending food ahead with the tour guides. I’ve always wanted to go to Everest, and I’m not going to let my disease stop me from doing it, and this is the time to do it. I’m just going to be very meticulous about how I plan and have a great time.

Mary:

I think that’s great, Kevin. What about eating out of the country like Mexico, Europe, how do you handle that?

Kevin:

I was recently in Switzerland, and it’s no different than anywhere else. I’m on a low fiber diet, so unfortunately it will be some type of white flour croissant and just plain bread or meat and cheese and just plan meals, and it’s there worldwide. You just have to communicate what you want and only eat the food you can eat.

It’s as simple as that.

Jill:

I backpacked through Europe, and I kept a lot of food like applesauce and little tins of tuna fish in my backpack. When I would get to restaurants, I just had to figure out, according to what it looked like, whether or not I could eat it.

Mary:

Well, both of you have had Crohn’s for quite a while, and so you have come to terms with dealing with it and how to handle it. I would think that Mexico might be a real challenge.

Jill:

I’ve been in the Caribbean. I’ve been in Key West and the Bahamas, and next year we’ll probably be going to Grand Cayman. Any country that you go to you have to check out the health precautions you need to be taking. The Center for Disease Control Web site is the key to knowing what types of vaccinations you need and what types of food problems that they have there. When you travel out of country, you should know the phone number of the American Embassy or the Canadian Embassy. These embassies can help you find good medical care should you be out of the country and encounter some problem with your Crohn’s disease.

They can also interpret for you. They are there to help you and protect you, and you should rely on that to find good medical care, but also you should check out your insurance plans before you even leave the country.

You need to know what’s covered and what’s not covered, and sometimes you can buy trip insurance for something as simple as $75. If you need to be airlifted out of the country, instead of facing a $20,000 bill you’d be paying just that $75, which would cover it. You need to check your insurance plans and your travel agent beforehand about how to purchase that coverage.

Mary:

Jill, you spoke about being in the Caribbean, what did you eat when you were down there?

Jill:

If we had fresh fruit down there, it had to be peeled. We had croissants in the morning. When we had fish, it was baked, and we stayed within the resort, pretty much. I didn’t want to eat anything that came from a street vendor. If I had to, I would buy things like Rice Krispie treats and keep them in my purse in case I needed a snack to replenish my energy.

Mary:

With summer approaching, there will be a lot of invites to picnics and parties and weddings. One way to be prepared for a social event is to bring your own dish, so I have a few Crohn’s friendly recipes I would like to share with our audience. Please keep in mind that everyone has different triggers, so these recipes might not be appropriate for you specifically.

Parmesan Chicken

Ingredients:

Boneless, skinless chicken breasts

Lactose-free butter/margarine

Bread crumbs

Lactose-free parmesan cheese

Directions:

Melt about 1/2 cup of butter/margarine and pour it onto a plate.On a separate plate, mix together an equal amount of parmesan cheese and bread crumbs (maybe a little more bread crumbs). Coat each piece of chicken in the butter and then roll it in the parmesan cheese mixtures until it is coated.Place the chicken on a baking sheet covered with foil.

Cook the chicken at 350º F for about half an hour, or until the chicken is thoroughly cooked.

(Recipe by Rachel Greenstein. Reprinted with permission from Teens with Crohn’s.)

There you go. That’s Rachel’s Parmesan Chicken!

So, that’s nice, especially if you are lactose-intolerant.

We have a couple of e-mail questions to read. Sebastian from West Henrietta, New York, is asking, “How does one prepare for a long trip, either vacation or travel to visit family, and deal with food issues?”

Jill:

One thing you can definitely do is plot out the road trip, find out where the bathrooms are located and while you are on those fast food Web sites, check to see which dishes would actually fit your diet because you’d be surprised. A lot of places like Wendy’s and McDonalds, and even Burger King, have menu items that are low in fat and low in fiber and not fried, but rather, grilled. You could eat a grilled chicken sandwich and a baked potato. Another thing you can do is pack your own food. Keep a cooler with all of the food that you would be able to eat such as a grilled chicken breast or cooked vegetables, pasta salad. Make sure, also, that you take a lot of water with you.

If you are going to be taking a plane trip, make sure you have water because we may also be suffering from dehydration if we have a lot of diarrhea at the time. Tell the people on the flight about your condition. When you get to your destination and you have to deal with the relatives, explain ahead of time what your dietary concerns are. Most of them probably already know this. And if not, when you get there, make a trip to the grocery store and buy the things that you need during that time.

Mary:

John, from Irvine, California says, “Can altitude cause Crohn’s flares? I heard this from a doctor once. I assume he meant elevations about 5,000 feet or plane flights could trigger Crohn’s flares.” Kevin, what do you think?

Kevin:

I’ve traveled extensively, and I haven’t had a trigger from being on a plane. I think one time I was coming back from Hawaii, and I had the milk and cookies right before we landed, and that didn’t go well. Everybody is very individual in regards to how they deal with the disease. If you have anxiety of flying and your stomach is going to be churning from the anxiety before you even get on board, that isn’t going to assist you. But if you are nice and relaxed and you love to fly, and you are in a good mood, that can help.

Mary:

Rebecca from Seattle says, “Are there things out there like Beano or Lactaid, for instance, that allow you to eat food you wouldn’t normally touch?

Jill:

There’s nothing you can take for fried food. There is nothing out there that is going to break down that fat and make it easier for you to digest. So, no as far as that’s concerned. Beano would work for gas, Lactaid would be for lactose. You just have to learn what you can eat and what you cannot eat. I love cheesecake. But I know if I go out and eat cheesecake, I’m going to spend the rest of the time in that restaurant bathroom or stop several times on the way home. So, instead, I get the cheesecake to go. That way, I can have the cheesecake and eat it too, but also be in my own bathroom later on that night and not making my friends wait behind or anything like that. You just have to figure out what your limitations are.

Mary:

Jill, you mentioned earlier that sometimes you take Imodium before you go out. Does that help with the cheesecake?

Jill:

No, it does not. But it does help with air travel. I try not to eat before I get onto a flight. I always go in there without eating beforehand and take two or three Imodium before I get there. I’m able to make it through the security line, I’m able to have something to eat, I’m able to get on the plane, and maybe I’ll have to use the bathroom once or twice, but I know how to get through it.

Mary:

Kelly, from Tuscan, Arizona asks, “When I go out with friends, everyone is drinking and having a great time. I just want to be able to have a glass of wine and socialize when I’m out, but it makes me sick. It’s not worth going out if I can’t enjoy the evening like everyone else. What can I do?” Kevin, what would you say to her?

Kevin:

Well, it’s no different than if she was an alcoholic, and she couldn’t drink, and she still wanted to go out. Your evening shouldn’t be based on alcohol content. If your friends drink, that’s fine. I go to Canuck games or Seahawk games, and everyone around me is drinking. Sure, I’d love to drink, myself, but I don’t. You have to be comfortable with yourself and still have a good time without alcohol. You learn what your body can do. You just have to enjoy your life as best you can with the limitations of the disease.

Jill:

I think keeping a food journal is also helpful, don’t you think, Kevin?

Kevin:

Yeah, that’s helpful or even going through the elimination diet, where you re-introduce things. You might find you might be able to tolerate some alcohol if that means the difference between having a good time and not having a good time. That might work for you.

Jill:

I love a glass of wine when I’m out with my friends, and it was doing the same thing to me. And I figured out I’m allergic to sulfites.

Mary:

So you can’t have red wine?

Jill:

I can’t have even white wine. Sulfites are in both because they use it to stabilize both (red and white wine). But what I did learn is that there are some sulfite-free wines, and I could also enjoy a Cosmo instead and not have the diarrhea with it. So you just have to figure out what it is that really bothers you. It may not be the wine, it may be the sulfites that are in the wine. In some places, you can find sulfite-free wine, organic wine, for example, does not contain sulfites. But you have to really know what it is that’s bothering you, and the elimination diet is perfect for that.

Mary:

How do people find out about this elimination diet?

Kevin:

Your registered dietician should be able to help you. Here in Vancouver, we have something called Dial-a-Dietician, which is a free nutritional service put on by the government. It’s staffed by registered dieticians, and you ask the registered dietician for assistance.

Mary:

I have another recipe that I want to share.

Soy Cheese and Macaroni

Ingredients:

1 tablespoon of soy margarine

1/8 cup of flour

1½ - 2 cups soy milk

your favorite soy cheeses

your favorite cooked pasta

Directions:

Melt margarine and add flour, stirring and cooking until almost brown. Stir in milk and continue stirring until thick. Add cheeses to taste.Continue cooking until cheese has melted; add to cooked pasta.

(Reprinted with permission from Teens with Crohn’s.)

We have a question from Janet from Walkwall, Texas, “I have Crohn’s. I love eating spicy foods. However, it hurts me about an hour later. Is there anything I can do to eat spicy foods without upsetting my Crohn’s?”

Kevin:

When I go to a Mexican restaurant, I get no beans, no salad, just the rice and the Colorado sauce on top. It’s quite mild, and I find that I can tolerate that. She’s going to have to find a level of spice that will not affect her within an hour, so try to tone it down and get to a level of sauces and spices that don’t cause an adverse reaction to her. That would be one recommendation, another is working with a dietician.

Jill:

Another recommendation is to see if it’s the cheese that’s bothering you. Lots of Mexican food has cheese on it. Maybe it’s the beef dishes and not the chicken. Sometimes you can get a chicken taco instead of a beef taco, or even a fish taco, and it won’t bother you the same way because red meat is more difficult to digest. You need to figure out exactly what it is that’s bothering you. And that way, the next time you go, you can really enjoy it without having the pain.

Mary:

That makes sense. It does sound like eliminating things and really paying attention has a lot to do with it.

Jill:

Absolutely. Focus on which part of that Mexican food is bothering you – is it the beef? Is it the cheese? If it’s just the whole experience, then maybe you should go with Japanese food.

Mary:

We have another question from Wanda in Miami, Florida, “What can a Crohn’s patient do about the pain and the passing of gas in a crowded room – other than running to the restroom every two minutes?”

Kevin:

You should know what foods cause that for you, so you can try to limit that. If you know that you are going to be in a crowded situation and you know that the food you are eating at lunch is going to cause you gas, well, change what you are going to eat for lunch. But you want to try to go to the bathroom if you can.

Jill:

If you know you are going to have a business meeting at 2 in the afternoon, then you probably shouldn’t have fried jalapenos at lunch because of what it’s going to do to you. Have the plain turkey sandwich instead and be responsible for yourself and what’s happening with you, so it doesn’t impact everyone else. However, if you catch yourself in that situation and you realize that you are having a lot of gas and it’s going to be uncomfortable, then, excuse yourself, go to the restroom and deal with the situation there.

Mary:

Elaine from Florida asks, “Even though I have been in remission for the past three years, I still have difficulty whenever we go out to eat. I order what I think is safe, and then I go to the bathroom to get sick. How can I avoid this without stopping eating out with my family and friends?”

Jill:

Even if she’s making safe choices, sometimes having this disease can be very uncomfortable, especially when you are out in public and you are not sure what kind of restroom access you’re going to have. It helps again to first find the restroom, go in there and wash your hands so that you at least know where it’s located and that you are going to have access to it.

I have half of a colon because of the surgeries I’ve had, and I’m missing three feet of my small intestine. And because of that, I will have diarrhea whether or not I’m having serious Crohn’s symptoms at that time. Because of that, I know, even if I have safe foods, I’m still going to have to use the restroom. And I just try to make the most of the situation, to relax and enjoy my family. They know that I’m going to have to get up sometime to use the restroom. When I come back, I always say, “What did I miss?” and usually they give me a brief recap. They know it’s going to happen, so I’m pretty relaxed about it.

Mary:

An e-mail from Sacramento, California asks, “What do you do if you receive bad service, or the waiter is unwilling to accommodate you?”

Jill:

Talk to the manager.

Kevin:

It comes down to communication. With most experiences, whether you are getting your car fixed, or anything else, if you are getting bad service, it’s your choice whether to go back or not.

Mary:

Jeanine asks, “When I eat, my colostomy bag begins to fill right away. Because of this and the odor that accompanies it, even with the proper odor killers, I tend to only eat at home. This makes for a very long day filled with hunger and lack of energy. Do you have any suggestions?”

Kevin:

The site www.badgut.com is the Canadian Society of Intestinal Research. They have a newsletter and an “Ask the Ostomy Nurse” column. I think that question would be a perfect one to send to badgut.com. I’d refer that question to a professional.

Jill:

When bags that fill and you know that it’s filling, it might be a good time to get up and see if you can empty it in the restroom. It might be uncomfortable to do so in a public situation. But since this is a permanent condition, it’s something that you’ve got to get used to. And you certainly should never, ever feel that you are trapped within your home with any of these conditions. There are definitely ways of getting around it. There is another Web site that I could refer her to, which is, United Ostomy Association of America. There are different chapters. And if you go to one of those support group meetings, chances are you are going to be meeting a lot of people who have been in the same situation you are, and they can tell you how they handle these particular situations.

Mary:

We have received several questions about dating. And Missy from Lake Elsnore, California asks, “How do you handle dating? You know, first dates are usually going out to dinner, right? I don’t want to lie, but I don’t want to discuss my illness with someone I don’t that well, either.” Kevin, how did you handle it when you and your wife got together?

Kevin:

I told my friend I wasn’t going to tell her about her my Crohn’s, and it was about 10 minutes into the date and I told her. And we’re coming up to 10 years together. It’s just one of those things. I’m pretty open with it, and she saw me through two surgeries, and so I’m very thankful for it. You want to be comfortable and not make it a big issue. You have it. People have diabetes, people have heart disease – people have lots of different things. You might want to do your first date somewhere else, like a rock climbing club or walking around the park and make the second date a restaurant, so you can get a feel for the person before you wish to tell them about your disease.

Jill:

I would suggest going to a pasta restaurant. An Italian restaurant is more likely to have something that you can chose without having to discuss your Crohn’s. If you don’t have the choice over something like that, look over the menu and be careful with what you choose You have to figure out what you are comfortable with. That’s the whole key to it.

Mary:

When you met your husband, was it right out in front, like Kevin?

Jill:

I’ve known him since I was 16, I’m 38 now. We didn’t start dating until I was almost 20. And his father is a gastroenterologist. I wasn’t diagnosed until after we had started dating. So he’s known the whole time that I’ve had Crohn’s, and his father is an expert in the disease, so it’s never really been an issue as far as that’s concerned. But I know that as far as employers are concerned, I always tell them right during the first interview – I do not belief in hiding this. I know what is out there and also they may know that I’ve written a book about Crohn’s disease and ulcerative colitis, so I tell them right away. I have this disease, it’s in remission currently. I take certain medications for it, but I’m able to do all that the position is required. So I’m very up-front about things like that.

Mary:

Jill, can you tell us again your book that is coming out in the spring?

Jill:

Actually, I have two books. The first one is the second edition of the first book that I ever wrote, which is called, “The First Year of Crohn’s Disease and Ulcerative Colitis” It is one of the best-selling books on the market for Crohn’s disease and ulcerative colitis. It should be in the bookstore any day. My second book is called, “The Five Gifts of Illness: A Reconsideration.” I interviewed 102 people across the United States and Canada who had chronic or acute life-threatening illnesses. I talked to them about their lives before their diagnosis, during their diagnosis, and treatment and their lives afterwards. I talked about all of the things that happened to them that were bad, but I also focused on how their lives changed for the better, and that’s where we came up with “The Five Gifts of Illness.”

Mary:

And Kevin, what are your Web sites?

Kevin:

The foodvancouver.com is for Vancouver, foodseattle.com for Seattle and toronto.foodontario.com for the Toronto region. Please send me your comments. I’m always trying new things to improve the sites. I have iPod guides, so you can actually search on your iPod for restaurants that are accommodating to dietary needs. And it’s just a great resource, and it’s more of a passion for me over the last 18 months.

Mary:

Kevin, are there any last words you’d like to leave us with?

Kevin:

Just don’t let the disease rule your life. There are going to be days where it is rough, but always think positive, and you can do anything you want to do.

Mary:

Jill, how about you?

Jill:

Realize that there is a life to be lived outside of your bathroom. It may involve a little more planning and asking a few more questions than others have to ask, but you can do it.